Difference in detection results and antimicrobial resistance of multidrugresistant organisms in intensive care unit and nonintensive care unit

Abstract:

ObjectiveTo understand detection results and difference in multidrugresistant organisms (MDROs) in intensive care unit (ICU) and nonICU. MethodsStrains isolated from clinical specimens of hospitalized patients in a hospital from January 2015 to December 2016 were analyzed, 6 kinds of MDROs were conducted targeted monitoring, isolation and antimicrobial resistance of 6 kinds of MDROs from ICU and nonICU patients were compared. ResultsA total of 1 013 strains of 6 kinds of MDROs were monitored, isolation rate was13.13%. Isolation rate of MDROs in ICU was higher than that of nonICU (24.60% vs 5.47%, P＜0.001）. Carbapenemresistant Acinetobacter baumannii(CRAB) was the main isolated MDROs, accounting for 69.40%；of different pathogenic organisms, isolation rate of CRAB was the highest (55.75%). The main MDROs detected in ICU and nonICU were both CRAB, accounting for 76.32% and 48.62% respectively； Of isolated pathogens, isolation rate of MDROs in ICU was higher than that of nonICU (47.95% vs 8.02%, P<0.001). Antimicrobial resistance rates of Escherichia coli isolated from ICU to ticarcillin/clavulanic acid, ceftriaxone, cefotaxime, cefepime, imipenem, meropenem, amikacin, and gentamicin were all higher than that of nonICU, resistant to piperacillin was lower than nonICU, difference was statistically significant (all P≤0.05); resistance rates of Klebsiella pneumoniae from ICU to common antimicrobial agents (except piperacillin ) were all higher than nonICU(all P<0.05). Resistance rates of Acinetobacter baumannii and Pseudomonas aeruginosa from ICU to common antimicrobial agents were all higher than nonICU (all P<0.05). Resistance rates of Staphylococcus aureus isolated from ICU to oxacillin, ciprofloxacin, tetracycline, and rifampicin were all higher than nonICU (all P<0.05), and resistance rates of Enterococcus faecium to quinupristin/dafoeleptin and tetracycline were both lower than nonICU (both P<0.05). ConclusionIsolation rate of MDROs in ICU is high, resistance rates to most antimicrobial agents are also higher than nonICU, monitoring on MDROs in ICU should be strengthened, and according prevention and control measures should be formulated.